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Opioids Put Death Rates on Worst Case Scenario Track for the Nation

December 21, 2017

Washington, D.C., December 21, 2017 – In 2016, 63,632 Americans died from drug overdoses, an increase of 21 percent over 2015, according to data released by the Centers for Disease Control and Prevention (CDC) today.  This represents a 50 percent increase over five years and 225 percent increase since 1999.

Trust for America’s Health’s analysis of the data found that:

• Overdose rates increased in 40 states and Washington, D.C. between 2015 and 2016.
• Seventeen states had increases of 25 percent or more. The largest increases were in Washington, D.C. (109 percent), Maryland (59 percent) and Florida (46 percent). Rates decreased in nine states.
• The highest 2016 drug death rates were in West Virginia (52.0 per 100,000 deaths), Ohio (39.1 per 100,000 deaths) and New Hampshire (39.0 per 100,000 deaths).
• In 2016, 24 states and Washington, D.C. had rates above 20 per 100,000 deaths.  In 2005, no state had a rate above 20 per 100,000 deaths and only five states had rates above 15 per 100,000 deaths.

Around two-thirds of these deaths were opioid-related.  The increase was largely driven by the continued escalation of deaths from fentanyl and other synthetic opioids –topping 19,410 in 2016, up from 9,580 in 2015 and 5,540 in 2014. This is an increase of more than 70 percent for a third year in a row – highlighting the evolving nature of the opioid epidemic, expanding to include more lethal, illicit drugs.  Heroin-related deaths totaled around 15,500 and there were 14,500 prescription painkiller deaths. Death from all other drugs other than fentanyl and other synthetic opioids only rose by 3 percent.

The rapid rise in drug deaths is putting the country on a “worst case” scenario track – where these deaths could reach 163,000 per year by 2025 if recent trends hold, based on projections in a recently released TFAH and Well Being Trust (WBT) report Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy.  The report calls for a comprehensive, multi-prong approach to respond to the “despair deaths” of drugs, alcohol and suicide – from immediate harm reduction to a long-term strategy to bolster the nation’s resilience.

“The escalating growth of opioid deaths is downright frightening – and it’s getting worse,” said John Auerbach, president and CEO of TFAH. “Every community has been impacted by this crisis and it’s getting lots of headlines, yet we’re not making the investments or taking the actions needed at anywhere near the level needed to turn the tide.”

“These are not simply numbers – these are actual lives. Seeing the loss of life at this dramatic rate calls for more immediate action,” said Benjamin F. Miller, PsyD, Chief Policy Officer, Well Being Trust.  “Our fractured approach to a multi-systemic issue isn’t enough and it isn’t working. We collectively need to take a more comprehensive and systemic approach, beginning with prevention through recovery and treatment, to double down on investing in systems change for real results.”

Additional TFAH Analysis

• Certain demographics had particularly high rates of drug overdoses in 2016, including: men (26.2 per 100,000) and 35 to 44-year-olds (35.0 per 100,000).
• Synthetic opioids including fentanyl had the largest increase in the number of deaths between 2015 and 2016 (103 percent increase); heroin and natural and semisynthetic opioids (including most commonly prescribed opioid medications) also increased by 19 percent and 14 percent respectively.
• Synthetic opioid death rates have been increasing dramatically in the past few years. In 2013, deaths were at 1.0 per 100,000; in 2014, 1.8 per 100,000; in 2015, 3.1 per 100,000; and in 2016, they reached 6.2 per 100,000. This a six-fold increase in three years.

Notes: The CDC’s National Vital Statistics System data has a separate category for methadone and does not include it in the fentanyl/synthetic opioid category. The state death rates from CDC are age-adjusted. See CDC’s reports Drug Overdose Deaths in the United States, 1999–2016 and Drug Overdose Deaths in the United States, 1999–2015 for additional data and analysis.

Recommendations from Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy

Pain in the Nation calls for the creation of a National Resilience Strategy that takes a comprehensive approach by focusing on prevention, early identification of issues and effective treatment. The report highlights more than 60 research-based policies, practices and programs, including:

• Improve Pain Management and Treatment by helping people heal physically, mentally and emotionally. Approaches must acknowledge that there are different types of pain and experts from mental health, medical care and other disciplines must develop team-based solutions that focus on proactively addressing pain before it gets worse.
• Stem the Opioid Crisis with a full-scale approach – including promoting responsible opioid prescribing practices (such as provider education and best practices for Prescription Drug Monitoring Programs); public education about misuse and safe disposal of unused drugs; “hotspot” intervention strategies; anti-trafficking to stop the flow of heroin, fentanyl and other illicit drugs; and expanding the use and availability of rescue drugs, sterile syringes and diversion programs.
• Address the Impact of the Opioid Epidemic on Children – and the Need for a Multi-Generational Response that includes substance use disorder treatment for parents and wrap-around services for children and families, including grandparents and other relatives who help care for children, and expand support for the foster care system. Model programs have been twice as effective in helping mothers achieve sobriety, reduced state custody placement of children by half and had a return on investment of $2.22 for every $1 spent on child welfare programs.
• Expand and Modernize Mental Health and Substance Use Disorder Treatment Services – Toward a Goal of Focusing on the “Whole Health” of Individuals by prioritizing innovative integrated delivery models for rural and underserved urban areas and expanding the provider workforce, including those who can deliver medication-assisted treatment. Some effective substance use treatment programs have a return of $3.77 per $1 invested.
• Prioritize Prevention, Reduce Risk Factors and Promote Resilience in Children, Families and Communities by limiting trauma and adverse experiences, which have the biggest long-term impact on later substance misuse, and promoting better mental health. For instance, nurse family home visiting programs have a return of $5.70 for every $1 invested, and early childhood education programs have a $4 to $12 return for every $1 invested.
• Reboot Substance Misuse Prevention and Mental Health in Schools by scaling up evidence-based life- and coping-skills programs and inclusive school environments and increasing the availability of mental health and other services.

Top school substance misuse prevention programs have a $3.80 to $34 return for every $1 invested; social-emotional learning programs have an $11 for $1 return; and school violence prevention (including suicide) programs have a $15 to $81 for $1 return.

The Pain in the Nation report was supported by grants from WBT and the Robert Wood Johnson Foundation (RWJF).  Data analysis and projections were provided by the Berkeley Research Group.

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.  Twitter: @HealthyAmerica1